| NPI | 1396409439 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95018846) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95074119) | 
| Enumeration Date | 2021-10-25 | 
| Last Update Date | 2022-01-26 |